B (5:01)

And everyone understands that concept. But would you agree that very few people actually follow that guidance? Right. Because it feels, it feels right not to.

A (5:12)

Yeah. In fact, I think there's a guilt when we do that. You know, a lot of parents will say, literally, you know, yeah, I don't have time for that. You know, I'm devoted. You know, my, my kids therapies, their education, sports Schedule whatever it might be, their needs. Particularly if you're parenting a child with special needs, it consumes your life, it consumes families. And I hear over and over again from parents who will say, you know, no, not now. That's not what's important to me. And I think that the families that really, the parents that do take some time to focus on their own health and wellbeing, in effect end up being more effective and have more joy. And I see their kids thrive when their stress levels are addressed.

B (6:04)

Yeah, no, it makes so much sense to me now, but at the same time, I think in the throes of it, it's just easy to discount or to kick the can down the road. Yeah, I'll take care of, I'll prioritize myself later. And it's just, I know I was kidding myself. And, and for the many parents I've had the honor of coaching, everyone does the same thing. They neglect their self care. And I guess the only way that I really found that I can, that I was able to really implement it myself is when I equated it to something more, maybe more tangible, like sleep. Because it's easy for us to say, you know, I don't need, I can get by on less sleep. And you know, there are people like, I'll sleep when I die, that type of thing. But if you really do ignore sleep and don't prioritize it, it's easy to see how everything comes off the rails. So for me, general self care was harder for me to implement. But taking this concept of sleep and me seeing firsthand how that negatively impacts me helped me to more generalize it to my overall self care. But I know it's a challenge for parents to take this in.

A (7:14)

Amen. And my story is no different. You would think a pediatrician, my wife is a psychologist. We have it figured out. We've got all the tools and everything. But I will tell you that when my kids were younger and I was starting the whole child center, I was really stressed out. And all the things I knew to take care of myself, how I eat, how I sleep, how I exercise went out the window. Because what I was focused on was, all right, I'm starting my job, my practice. That's really, I'm serving other people. That's really important. I'm going to put everything I have into that. And my family and my kids at different times were struggling. And I felt like an awful parent. I felt like a fraud. Where I would show up to work each day as a pediatrician, and what is my job? To counsel parents how to take care of their kids. And I'm going home each night and really struggling and not, you know, I was really in a tough place and really burnt out, to be honest with you. And it was a long, hard, slow road, but it really, what I discovered, the tools really weren't in my toolbox of medical care. And as a pediatrician, it was really when I embraced mindfulness practices, you know, so for me that was yoga and meditation and I had no choice at that time. I really was breaking down and it was that or completely burnout. So in order to serve myself and my patients and my family the best I could, I just surrendered to this idea. I'm going to, just going to show up to yoga class. I'm going to. People keep saying it's a good thing to do. I was prescribing it, I thought it was an amazing thing, but I wasn't doing it. And then when I started the lessons around awareness, engagement, presence, how could I show up for my family, for my kids, for my patients to be authentic and honest and true and at the same time take time for myself? Those are the lessons I started to learn and started to apply.

B (9:21)

Yeah, that really comes down to balance. But you can't balance something if you don't think it's important, right?

A (9:27)

Right, yes.

B (9:28)

And I'm guessing in all your, in your training that you went through to become a pediatrician, there was very little of this that was taught to you. Well, maybe that's different now, I don't know. But otherwise, the idea of you taking time for yourself to focus on presence and to not ignore your self care, I think you put it into practice as you said, because you kind of had to. And I think all of us parents also usually only learn things when we are forced to. So it's great to be able to have the insight and to take action before it becomes absolutely necessary.

A (10:08)

If you're listening to this and you're a parent, whatever you do otherwise, what I would want people to know is that it's okay to take time to develop your own health practices and we can talk about how to do that. I mean, I think you as a coach use these kinds of models. I, as a physician coach, use models that are, whether we call them smart goals or health coaching or whatever the techniques to break that down, but to give yourself grace and permission to do that, I think that's critical. And the thing, the lesson we've learned in integrative care is you start with what Matters to you. So if I say to you, as you know, you're a paranoid practice or your patient, I want to know what's going to motivate you. I want to know what's most important to you. Maybe that's, I, you know, I want to spend time with my child. I want to live a long life to see my grandkids. I want to really develop this expertise in this job area to serve other people, whatever it is. Getting in touch with that. And so you asked about. No, physicians are the worst patients. We are not trained that way. I like to believe. So I now teach at the Hackensack Meridian School of Medicine. That's half of my work. In the same way I work with my young patients, I work with our students around health and coaching. And the whole course that we teach there, the human dimension, is predicated on this idea that we need to teach young physicians about the human side of medicine for their patients and for ourselves. So I like to think we're doing a better job. I think we are. And the culture is still really, really challenging. And that's true of a lot of cultures too. Even the parenting culture, right? Is often, no, like you said, I'll sleep when I die, I'm going to grab some, I'll hit up whatever fast food place and grab something quick because I have to get home and make dinner for my kid or whatever it is, right? That's how we live our lives. So I think if we can all try to take a step back and think about what's in the service of our family's health and wellbeing, I think that that's a good way to start.

B (12:31)

No, that makes perfect sense to me and I think you touched on it earlier, the word permission, where I think many parents, they don't need someone else's permission. But I think in a forum like coaching or a forum like the patient, you know, doctor relationship, that is kind of the environment where parents can see the opportunity to allow them to invest in themselves to prioritize their self care. And that's hard for a lot of reasons. But one very big reason is that that's not the playbook our parents taught us. So it really does mean choosing a different path and prioritizing self care where maybe that wasn't modeled by your parents and grandparents and likely wasn't. So I think it is a different way of operating, which again to me isn't optional because otherwise it can only lead to burnout.

A (13:26)

Now I'm imagining there are people listening saying, that's Selfish self care is selfish, right? I mean that's, that's a hidden, or maybe not even such hidden messaging. You know, in certainly when I was growing up and my, when I think about, I was very lucky. My parents really did role model a lot of really healthy and good behaviors. And so I know I'm fortunate that way. And even with that, it's been a struggle. And part of that is, you know, again, I think there's a sense that if we, particularly when you become a parent, that if that's not your only priority, you're not as good a parent as you can be. Right. And again, I think there are a lot of practices that people can do. It's a mindset and mindsets can be learned and practiced. I think both you and I believe that strongly, otherwise we wouldn't be coaching people. And I know for myself there are certain things like if it's practicing gratitude or practicing compassion or practicing just being present in the moment, these are practices I can do and I know I need to do day in and day out. When I go to see patients in my office before I enter an exam room, 100% of the time I stop, I pause, I take a breath in and out, and I just bring myself to the present moment so that when I walk in the room, whatever's going on in my personal life in my office and the prior patient I just saw, I set that aside and I walk in and I try to be fully present. And that's a practice.

B (15:04)

No question it's a practice. But it starts with that intention, right? Which I think unless you have that intention and that's where you're right, it is mindset. From the way I look at it, it's the mindset, yes, attitude, but it's also just these beliefs that we hold, these stories that we tell ourself. And that's where a lot the root cause of what's holding a parent back lies. Because there may be stories we're telling ourselves that we are certain are true, but that just aren't and don't help. You know, like it's as you said, the story was for me that was playing for sure was that it's selfish to prioritize myself. Now my child needs me. I'm 100%, 110% of me is going to be devoted there. So again, there's these stories that we tell ourselves that are well intentioned and that we're certain that they're true, but they actually are the source of a lot of the friction that we can do without.

A (15:59)

Yes. Yeah. And I think that's really, really important, what you said. I think that we can support each other as parents and in the community. Sometimes at our office, we'll hold evening events or workshops. You know, we invite parents and we ask them, what's the best time to do that. The truth is never, you know, we'll have one person show up or two people. And when we ask, you know, well, what was the content? Not valuable? No, no, no. We want to hear about, you know, whatever you have to offer. We're just. We don't have time, you know, in our family life and our schedule. And I get that. And so I think that we have to meet people where they are. But I also think for me, what worked was having something really tangible and practical that I could do and I could offer to families in our practice, so having structures and models to do that. So I come from a. I use an integrated model called the Whole Health model, which is sort of becoming nationally the dominant integrative medicine model. You know, it was piloted in the VA system and now has become the patient care system for the entire Veterans Administration healthcare system, which is one of the largest single payer systems in the world. You know, we're talking about many, many, many patients with special needs, you know, many, many vets, you know, with PTSD and other mental health needs and significant physical needs. This model is built on several things, which is thinking about health in a really holistic way. So you think about, yes, you think about nutrition and exercise and sleep and rest. You think about stress coping. You also think about community. You think about the connection to other people. So thinking about the impact of isolation, which, again, for families with special needs kids, is a real issue, becoming isolated. And then the other thing is really thinking about how do we spend our time in thinking about, again, what matters to me the most, the purpose, the sense of. And maybe for some people, that's a spiritual question, and that's finding, you know, something, some greater meaning than ourselves. Doesn't necessarily have to be religion. It could be nature, it could be something else or some service, you know, in service of other people. For me, I find that in my medical work, you know, in my teaching work. So connection to purpose and connection to social connection, those are parts of this model. It's also done in groups. So we bring people together in groups. So it's a hybrid model where I might be working with somebody individually or family, but we can also set up group meetings. And that's something that when people look, we all Live and work in communities. And we don't necessarily think about communities as healing, but there are structures that are available to us. Maybe that's a faith based organization, maybe that's a school, maybe that's. Whatever it might be. But just thinking about health in that way, I like to have that structure. So I could sit down with, I could sit down with you if you're my patient. And I can say, let's go through. And here's a way to reflect on all of these areas. Quick, structured tool, right? A reflection tool. And you can think about that. Where do you think you are right now? Where would you like to be? What's most important to you? Where do you want to start? And then we start saying, okay, let's work on a really specific measurable goal. Right? This kind of, this is transformative for how we work with families. But for parents and for families, if you're listening out there, you can do this on your own or you can work with a coach. But I think finding community around, if it's, you know, a community around a health identity or community around a belief or whatever that is, can be really supportive.

B (19:48)

Yeah, no, I couldn't agree more. And it, again, I don't know early on if I would have been able to hear that message and really take action because it is an isolating journey sometimes with what's happening with your child. And isolation feels safer in some ways than engaging community. I know I felt like engaging with community would kind of be a waste of time because I had work to do, focusing on my son. But again, in retrospect, it's easy for me to see now. But isolation is never the answer, you know, particularly from a health standpoint. We were designed to be in community. And there's so many benefits from, you know, not doing things 100% in isolation for yourself and your child. So community took me a long time to really understand and implement that concept.

A (20:37)

Yeah, yeah. No, I think that that's really important. But, you know, when I, when I meet with new parents for the first time, one of the things I ask them is, what are you curious about? What questions do you have? What are you learning? Where do you get your information from? And what I hear over and over again is other parents. Just yesterday, I think I was speaking to somebody and said, I heard from a friend, I heard from a mom about xyz. What do you think of that? Then this question comes up all the time. And as a physician, I could take several attitudes to towards that. One could be, oh, well, that's nonsense or, you know, there's no evidence and blah, you know, But I want to be curious and I want to, you know, I, I am understanding in that moment. What I'm hearing from you is this was a valued source of information, someone you trusted enough to ask me about it. Let's chat, let's talk about that. What do you know? What do I know? Let's be collaborative because at the end of the day, your decision as the parent about what you're going to do next, I firmly believe that. And so the information is often coming from other parents and other people. And today maybe that's electronic or social media or whatever. And I think we have to be very mindful and cautious about thinking about where information comes from and who we trust. But I like to think that if I can work with a family over a long enough period of time, whether we agree or disagree on a number of issues, we can trust each other, we can come to trust each other, and I can be a trusted source of information. Even if you make a different decision than I would with the same information, right?

B (22:23)

Yes. And then you used the magic word, which is why we're so excited that you were our guide, particularly early on. And that word is curious. Right. Not every practitioners curious. And so this might be a good time to talk a little bit about, if you could share, because I didn't about the whole child center. And I know you created that 20 years ago, before it was kind of fashionable. It was very, very cutting edge and still is, in my opinion. But if you could talk a little bit about the whole child center and then as you do that, I know I spend an incredible amount of time when I'm talking with parents, explaining to them the difference in terms of practitioners, particularly pediatricians, whether it's conventional, integrative, then there's biomedical and there's holistic, and there's a lot of terms that are thrown out there. So if you can help parents also understand integrative practitioners like yourself, that would be, I think, very helpful.

A (23:20)

Yeah, I think that's a great thing. And this comes up a lot because there are so many words and so many terms. So I'll tell you about my story and then I can put that in context of the greater landscape because I know parents are out there and whether it's functional medicine, biomed, you know, what's maps, what's, you know, and all these terms that come up. So I am a primary care pediatrician. What that means is that in my practice we see babies through right now we go up to 30 years old. So it's a really wide range of kids and young adults in the context of primary care. So we're your doctor, we're your medical home, home. We do the checkups and annual visits and we see kids when they're sick. And we take care of all the preventive health needs that families have. We fill out all the forms for schools. We work with families on 504 plans and IEPs and all this. You know, we're with the family. We are the nucleus, the quarterback, the hub, the home for all medical care needs. And because that's how I contextualize it, I think that's a really powerful model. There are other models and we can talk about that, but that's what I do. The reason I started the whole child center was because I wanted to work in a primary care space. That was two additional things that we don't see in all primary care pediatric spaces. Let's be honest, I'm in northern New Jersey, there is a pediatrician every mile. There are lots of wonderful practices. For me personally, what I needed was a more integrative model. So that that was a model that understood conventional western US therapies. Prescribing medications solely was not the only answer that there are other options. And I mostly learned this through patients coming to me and saying, what do you think about a gluten free diet for my child? Who's on the spectrum? The first time I heard that, I was like, what's gluten? Now I'm being really honest with you. That was not taught to me in medical school or if it was, I wasn't paying attention. So many other therapies, maybe that's from a traditional Chinese medicine background or ayurvedic background, or homeopathy, or acupuncture or mind body medicine, all these herbals, whatever nutritional. So I wanted to be able to integrate that. Whatever has an evidence based behind it. I could have conversations about. All that was one number two was to be ecologically sustainable. So for me, one thing I was witnessing was the impact that changing environment was having on our kids. Maybe that's plastics, maybe that's food, you know, production or water or whatever the issues were in the environment, I was seeing the impact and continue to see on my patients in real time. So I wanted to create an office setting that was the least harmful to the environment that I could make. So maybe that was a choice of paint, ceiling tiles, whatever it was. So those two things were critical for me and to create a Home where families could come and feel loved, cared for in that way and partnership. So we did that. That was almost 20 years ago. Now what I see is families will come to us and they're also looking for guidance around very specific therapies. Sometimes they want a pediatrician or someone who knows kids. So the pediatric background, but also understands supplements, herbs, ot, pt, speech, aba, chiropractic, you know, how do all those things fit together to create a plan that's very holistic and serves my child the best? So we do that in this context of primary care. But there are other physicians who do just consultative care. They're not your primary care doctor. You see them because they're trained in functional medicine. Really root cause, thinking about lab tests and supplements and how that works, very high level of training, but might not have a pediatric perspective per se, or might not have a primary care perspective. And there's great value. These are some of the people I trust the most when I'm looking for knowledge in certain more esoteric areas that aren't necessarily in my wheelhouse. But that's a different model, often costs more money, may not be as accessible. And so that's the distinction when I think about sort of consultative practitioners or functional medicine practitioners. We try to do it all as much as we can. It's not possible. And again, there are limits to what we can do. For example, we don't do IV treatments in our office or just certain things we don't do. So we partner, we work with other people, refer out, collaborate. We tend to be the home where people then come back and say, I met with so and so, whether they were a cardiologist or a chiropractor, it doesn't matter. You know, what did they say, what do they do? I can talk to them. Do I have permission? You know, all that. And there's the whole mental health perspective. So that's how we try to do it. I do think that you're seeing more also concierge practices and direct primary care where it's insurance is not accepted generally. And again, I know people who do that really well, families that love that kind of practice. We've tried to do more of a hybrid where we try to keep the out of pocket costs relatively lower than most concierge practices would to try to provide accessibility to most families. That's where I've sort of landed, to try to keep the doors open and serve as many people as we can. Right, yeah.

B (29:06)

To make it viable. Because again, I know our experience then and I'm sure It is now where when you regulate yourself before you go into the room with a family, once you're in the room, you spend time because you're asking questions, whereas the conventional model doesn't allow for practitioners to actually spend much time to really ask the right questions. So I think, yeah, you've created an environment, a very unique environment where parents can get more personalized perspective from a curious practitioner. And the way I always describe it is that you have more tools in your toolbox of things that can help, whereas I think more conventional practitioners may be more limited. So that's important. But. But again, it is a confusing landscape with all the different options available. So I appreciate you making clearer your. Your specific way of kind of bridging that gap. And I think it is a very unique lane.

A (30:07)

And time is in our toolbox, too. You brought that up because I think that's something I didn't really hone in on. We probably see half the number of patients per day that most busy practices do, and that allows us twice the amount of time, on average, with our patients. And that is the secret sauce. Honestly, whether I knew anything about acupuncture or chiropractic or homeopathy, that becomes much less important if I can only spend five minutes with you. You know, that doesn't really help. So, yeah, we've created a model. We have incredible practitioners that I work with, all of them, who I would trust. I do trust my kids with, you know, when they were younger, and I would stand by any of them, you know, and we all work in this model because we've seen how it's done other ways we've been as patients and as practitioners, and we do believe that this is the way of the present and hopefully the future.

B (31:00)

Fantastic. No, Wonderful. And again, I can't tell you, I can't express how much I know. Cass and I both felt so heard and seen. And again, I think you were just the ideal person at that time that we could have ever have had. So, again, I'm so grateful for your guidance. And I think as parents are listening to this, they're going back to the theme we started with, where, you know, it really is about decision making. And as Dr. Rosen just said, it's not him making decisions, it's a parent who makes the decisions. And he's a phenomenal guide to help you do that. But it's really impossible to make great decisions for your child or yourself, again, if you're not thinking clearly, if you're not regulated yourself, which is why this concept of Self care, which, yes, many people feel like some guilt for spending time there. It just isn't optional. And so how you do that, you know, that might be an art. I know with me it started with a few minutes a day. And then maybe I could build a practice where I'm meditating for 15 minutes, but just to start slow and at least make sure every day you're carrying in some way, in a way that feels good about, that you feel good about was. I know the key way that I was able to actually start to implement it. What would you suggest to parents who are looking to put this into action? What suggestions do you have?

A (32:21)

Yeah, I love that idea of starting with five minutes a day. And I think one thing I do. So I'm also a yoga teacher. And what we do in Mrs. Moran yoga workshop retreats that we do think about, take five minutes today and think about for the next month. Is there one thing that you want to add to your routine that you think will serve your health well? And is there one thing you want to let go of that doesn't serve you anymore? So an example might be, yes, I really. I keep hearing about meditation. I think it'll help my stress level and my blood pressure and my short temper with my kids. I would like to sit for five minutes a day and just close my eyes and breathe. And that's meditation, right? Just trying to be present and breathing for five minutes a day for the next month. That's what I'm going to try to do and I'm going to try to let go of. When I wake up in the morning, I grab my phone right away and I start looking even before I open my eyes. That's the first thing I'm opening my eyes to. You know, before I do anything else, can I give myself 10 minutes in the morning before I look at my device where I just sit, whatever, pet my cat, talk to my kid, grab a cup of coffee, look outside, whatever it is. So you let your. Just for a month. Can I do that every day? And those are the small goals. And then just set however you want to track that. A journal, your phone, whatever, whatever. However you track those things. And then at the end of the month, you check in with yourself without any shame, without any guilt, without any judgment, and be curious and say, how did it go? Did I? Oh, yeah. Five times this month I sat down for five minutes and I break. And then you say in that moment, you don't say, oh, I didn't do it. Every day I suck. You're like you don't do that. You pause and you say, good for me. I noticed five times this month that I did this. How do I want to go forward in the next month? So it's like that.

B (34:35)

Yeah, no, I think those are phenomenal. It sounds so simple, right? But those are power moves.

A (34:42)

It's hard, it's hard to do. But if you break it down and you have that intention, I think most of us can find five minutes a day to add a new habit, a new behavior. And that's the key, right? You're trying to make it a habit. And the letting go part too. I think we forget. There are a lot of things we do habitually that are probably not serving our health very well. And maybe there's one small thing, and maybe it's a self talk or story you're telling yourself you're going to try to let go of. That's hard work. But whatever, that small habit that you can practice for 30 days and you try to align that with your values. I know we're probably running short on time and I'm just going to finish with one quick anecdote which is, you know, I wanted to walk more in my life and to really expend more time in nature. And so I started telling myself this is sort of like atomic habits, you know, kind of stuff. I'm a walker. That's who I am, you know, and if I want to be a walker, I need to walk. So I started walking, you know, finding the time, 15 minutes here, there, you know, and then when, now when I have free time, it's like, maybe I should walk. Maybe that's what I should be doing. Not spending more time on my laptop or whatever. And aligning what you're doing with that.

B (36:01)

Yeah, absolutely. And yeah, I love it. And yeah, it is all about habits. And with routines, that's kind of how you can, you know, really take these things that you want to change and make them more habitual. And so that's where what you do first thing in the morning, what you do before bed, those are two great routines to look at and to see what is it that you can add excitedly. That's not something that seems too onerous, which is why just a few minutes of something done every day is so much better than, okay, I'm going to meditate for 45 minutes, you know, where there's, you know, just maybe way too high of a bar to. To start off with. Yeah. So I appreciate that suggestion. Thank you, thank you for that. And I would love to keep talking to you about going deeper on this topic because I think it's so important, but I feel like you covered some really key concepts and I'd encourage people. I'll put in the show notes, go check out Dr. Rosen's whole child center. And it's a dynamite team of people who are there. Very different practice. I know. I think you still have a video on the website that shows me and my son and my wife and my daughter all there. I think when my son was three. So again, I think if you want to get a taste of what the environment's like, that'll be in the show notes. And again, I just can't thank you enough for sharing your perspectives and for everything you're doing now with. I know you're splitting time and you're continuing to find different ways of paying it forward and helping families. So thank you so much for what you do, Dr. Rosen.

A (37:29)

I appreciate you having me on. I really cherish our, you know, our collaboration and partnership and friendship going way back many years. And you're right, that video is still our video on our website. So there's a time capsule there. And honestly, this is what brings me joy and purpose every day. I feel so lucky and grateful to wake up and be able to do the work that I do and to have that each and every day. Thanks for having me.

B (37:52)

Absolutely. Thank you. Your child needs you running on all cylinders now. And the fastest way to rise is with personalized one on one support. Get started today. Go to elevate. Activate how you navigate dot com.